The single standard practice for gaining peripheral venous access in a medical patient has not changed significantly in over 80 years. Typically, the standard practice involves the use of a tourniquet applied to an upper portion of a patient's arm. The application of a tourniquet stops the flow of blood to the heart and allows whatever pressure is available from the arteries and capillaries to fill and distend the veins. A medical practitioner, such as a doctor, physician's assistant, paramedic, or nurse, may then access the distended vein with a needle to draw blood, or insert a peripheral venous catheter or other such cannula into the distended vein to administer drugs or other fluids. This is a painful, sometimes dangerous, time consuming, and inaccurate method.
In a majority of patients, this approach is sufficient for either the drawing of blood for hematology analysis, or for the placement of an intravenous cannula to administer fluids, including but not limited to volume expanders (e.g., colloids (e.g., blood, dextran, hydroxyethyl starch, stroma-free hemoglobin), crystalloids (e.g., normal saline, Ringer's Lactate, glucose/dextrose, Hartmann's Solution), blood-based products (e.g., red blood cells, plasma, platelets), blood substitutes (e.g., oxygen-carrying substitutes), buffer solutions (e.g., intravenous sodium bicarbonate, Ringer's Lactate), nutritional formula (e.g., peripheral parenternal nutrition), or drugs including but not limited to antibiotics, analgesics or chemotherapy into the blood stream of a patient. However in most patients, geriatric patients or cancer treatment patients for example, gaining venous access can be difficult and problematic for any number of reasons, which may lead to medical practitioners requiring multiple repeated attempts to successfully gain intravenous access to the patient's vein(s). Repeated attempts, to gain venous access in a patient may result in a variety of adverse issues including hematomas, fluid infiltration into the surrounding tissue (which, with chemotherapy agents, can cause severe local reactions), pain, shock, discomfort, vasoconstriction, and in emergency situations, may require the practitioner to switch to either a central venous access approach or a “cut-down” (opening the tissue) to gain access to a vein.
There are many types of patients in whom these problems can result. Elderly or geriatric patients frequently have frail veins or are peripherally shut down due to dehydration. Pediatric and neonatal (newborn) patients are especially difficult to gain venous access to, due to small veins and the significant immaturity of their bodies. Patients who have lost blood volume through trauma, shock, or dehydration (such as ER and paramedic patients, patients injured in road traffic accidents or military combat, crush victims, famine victims, etc.) are likely to be peripherally shut down, making it difficult to locate and raise a vein, but are often the patients in whom medical practitioners most rapidly need to gain venous access. Obese patients are yet another patient group in which medical practitioners encounter difficulties in locating or raising a vein for venous access. Cancer treatment patients also present difficulties for medical practitioners to gain venous access due to, among other things, phlebitis.
Other methodologies and devices have been employed to attempt to locate target veins for venipuncture or determine when a proper and successful venipuncture has been achieved. However, such devices and methodologies are either passive and non-invasive devices and techniques, or they are invasive mechanical devices and techniques that actually first require the puncture of the target vein in order to determine the position of the needle within the vein (which does not otherwise aid in locating the target vein or increasing the ease of inserting the needle into the target vein). One example of a passive technique and device is the use of a strong source of visible or ultraviolet light placed against the skin of the patient in an attempt to read the reflectivity of the underlying iron in the patient's red blood cells in the target vein, through the patient's skin. While this passive technique may help to locate a target vein, it does not increase the ease of achieving successful venipuncture. Additionally, the vein will often roll away from the needle when the medical practitioner tries to inset it. The drawback to using active mechanical devices that need to puncture the lumen to determine the position therein is that, if the machine performing the venipuncture goes too far and pushes the needle completely through the opposite side of the target vein, the result is a double penetration of the vein requiring the tip of the needle to be withdrawn back into the lumen of the vein. Accordingly such mechanical techniques are flawed in that they permit the possibility of a double penetration which may result in blood leaking from the second vein puncture causing a hematoma in the patient.
Accordingly, there is a need for a more rapid, reliable, less painful, more efficient, safer, and repeatable method of distending a patient's veins in the hands, arms, feet, or legs to allow easier venous access by medical practitioners. In addition, there is a need for a medical apparatus that can cause a more rapid, reliable, and repeatable distension or expansion of veins in a patient's hands, arms, feet or legs across a broader patient spectrum including geriatric, pediatric, neonatal, and trauma patients, to assist medical practitioners in gaining venous access.